Reduction in initiations of drug-sensitive tuberculosis treatment in South Africa during the COVID-19 pandemic: Analysis of retrospective, facility-level data

• DOI: 10.1371/journal.pgph.0000559
• Publication Date: 2022-10-11T17:22:31Z
• Authors: Mariet Benade; Lawrence Long; Gesine Meyer-Rath; Jacqui Miot; Denise Evans; Jeanne-Marie Tucker; Harry Moultrie; Sydney Rosen
• Keywords: Pandemic

In response to the global pandemic of COVID-19, South Africa implemented a strict lockdown in March 2020 before its first COVID-19 wave started, gradually lifted restrictions between May and September 2020, then re-imposed December second wave. There is concern that COVID-19-related morbidity mortality, deprioritization TB activities, fear transmission, societal led reduction tuberculosis (TB) treatment initiations. We analysed monthly public sector, facility-level data from Africa’s District Health Information System (DHIS) January 2019 April 2021 quantify changes initiation numbers stratified by province, setting, facility type compared timing these case government levels. At 1189 facilities reported observations for all 28 months our study period, initiations were 20.4% lower than 21.9% four 2019. 3669 ≤28 months, declined sharply provinces May-August same After recovering somewhat last plummeted again early 2021. Percentage reductions larger urban peri-urban areas rural areas. Most experienced clear inverse relationship cases but little level. The responses it resulted substantial declines number individuals starting risked progress toward achieving management goals. Exceptional effort will be needed sustain gains combating TB.